Significance and Relevance of the Topic Area
The term critical appraisal refers to systematically analyzing a study which has been published in a journal. For the purpose of systematically analyzing a study it is needed to analyze it with the help of using a checklist of main questions. Thus it is with the help of the process of critical appraisal wherein the research evidence of a research is systematically examined wherein the underlying intension is to evaluate its results, validity and relevance prior utilizing the information for the purpose of decision making.
The topic area associated with the research which focuses on the issue of decision making for people with dementia is of great relevance to health science. It is due to the fact that dementia as a health condition is a progressive condition having no particular medication for complete cure or treatment of the condition. The complexity further increases due to the fact that in the treatment of dementia of dementia there are various decisions which are needed to be taken that includes ethical and practical issues (Livingston et al., 2010). Dementia being a progressive condition, in the later stage of the condition takes away the decision making ability of the care users, which makes it essential for the care providers to take decision on behalf of the care users. It is due to the above discussed aspects and facts associated with the condition which if dealt effectively in the particular research being backed scientifically, would result in making the topic area associated with the research significant and relevant to health science.
The originality of the study depends on the fact if there is any new dimension associated with the topic area of the research which has been highlighted on the part of the researcher. On the basis of this criteria if the chosen file is analyzed it may be observed that the study added to the topic area certain new aspect (Warner, 2013). The study dealt with the aspect of difficulties in decision making on the part of the individuals lacking the capacity of decision making which is frequently aggravated due to active resistance. The study further came up with the fact that the presence of legal authority is not adequate. In this regards it is essential on the part of the families to devise strategies for the purpose of overcoming barriers and gain agreement, which is a new dimension being highlighted by the study. In the process of decision making on the part of the carers they are needed to be provided with certain support wherein the chosen study would turn out to be effective. Considering these facts it may be stated that the study was original in nature.
Originality of the Study
The clear specification of research hypothesis in the chosen paper is questionable which is due to the fact that it has not been specified in a clear and specific manner. However, the paper does mentions about the fact in the unanswered questions and future research part, that on the part of the researcher it was hypothesized prior collecting the data that they will be able to establish ethno-cultural difference associated with help seeking (Khan, 2011). However, in reality it was observed that such difference were minimal.
The design of the study was that of qualitative study with the underlying intension of specifying decision areas with the help of focus groups and issue of decision making in individual interviews (Neuman, 2013).
The research design can be considered to be the appropriate way of evaluating the considered research hypothesis. It is due to the fact that the sample was large enough and had the variety needed to be present within the chosen sample for the purpose of determining the different issues associated with decision making in case dementia patients lacking the needed capacity (Lewis, 2015). It is due to the fact that the sample was effective in providing the opinion of care users, carers as well as family members. In addition to that the aspects associated with non-dementia health decisions were also taken into consideration which acted as a contributing factor in making effective comparison and come up with desired outcome associated with the research (Livingston et al., 2010). It is the present of diversity or variety within the sample group which was large enough to provide the researcher with an idea and establish the interlink between dementia patients who are not having the ability of decision making and issues of decision making in case of these patients.
In regards to the recruitment strategy, on the part of the researcher it may be observed that clear specification associated with the specification of the participants i.e. the number of participants and the setting which has been chosen has been clearly specified (Robinson, 2014).. In addition to that, on the part of the researcher clear specification regarding the inclusion criteria can be observed. In this regard on the part of the researcher it has been stated that on the part of the researcher that carers who has participated in the decision making process for care users with dementia has been included in the study. In addition to that, the researcher focused on inclusion of individuals belonging from diverse socio-economic characteristics along with individuals who are providing care services to individuals suffering from dementia and they are at different stages of the condition (Livingston et al., 2010). This has helped the researcher to incorporate in the study a varied range of experiences. Bereaved carers, newly referred and care users using care services for considerable time can also be seen to have been included in the study. On the basis of the above made discussion it may be stated that the recruitment strategy for the study has been in alignment with the research aim. It is due to the fact that the underlying essence of the research aim was to provide with maximization of variation associated with the experiences related to difficult in decision making among dementia patients which can be seen to have ascertained with the help of findings of the wide group. This puts forward the fact that the recruitment strategy for the study has been effective in nature.
Clear Research Hypothesis
In regards to justification of the method of data collection it is noticeable that the setting for data collection was Community settings in London. This has been helpful for the researcher in gathering wide range of experiences in regards to issues related to decision making among care users with dementia (Livingston et al., 2010). In addition to that it may be observed that the researcher has clearly specified regarding the focus group which consisted of five sections- spouses, individuals living in the care home, individuals with young onset dementia along with those individuals seen in primary care setting. There are also specification regarding the ways in which the interview was conducted which was performed with the help of semi-structured schedules which included a wide range of choices including facilitators, choices, barriers in regards to the decision making process. In regards to recording the data the discussion and interview was digitally recorded which was transcribed it vertibatim wherein the identity was removed. Thus on the basis of the above discussed aspects it may be stated that data collection method was effective in this research as it was impactful in collecting a wide range of aspects associated with barriers in decision making among dementia care users.
No such focus on the part of the researcher on relationship between participants and researcher may be observed which can be effectively established with the help of the fact that the issue of bias has not been focused upon on the part of the researcher.
On the part of the researcher it can be observed that ethical approval has been taken into consideration wherein relevant research ethics can be seen to approve the study (Livingston et al., 2010). It can be clearly noticed with the help of the fact that signed informed consent has been given by the participating family carers. In this process the data was shared and no additional data was available which further reinforces the fact.
The concluding note associated with this research lacks any particular backup or support provided by relevant data. It is in the portion of the research- unanswered questions and future research wherein the concluding note of the research has been presented. It is in this portion of the study in which the researcher has mentioned regarding the fact that there is lack of alignment between the hypothesis and the research findings (Livingston et al., 2010). In this part of the study it has been stated on the part of the researcher that the researcher has succeeded in establishing an alignment between family conflicts and its impact on issues associated with decision making. However, on the part of the researcher no specification or backup with data was given to the mentioned statement.
Study Design
The data analysis process used in the study has been clearly specified on the part of the researcher wherein it has been stated that qualitative research software programme- Atlas. Ti 5.2 has been used on the part of the researcher for the purpose of management, coding and analysis of data (Livingston et al., 2010). The researcher has also specified regarding the fact that thematic content analysis has been used on the part of the researcher. On the basis of this fact it may be stated that the data analysis was sufficiently robust.
Dementia as a health condition being progressive in nature, in its later stage takes away the ability of decision making on the part of the care users. In this alignment of discussion, like any healthcare services in case of dementia patients it also becomes essential to practice informed decisions in the process of providing the care users with care services (Prince et al., 2013). However, due to the condition being progressive in nature participating in informed decisions becomes a complex task. Considering the above discussed aspects, the topic area of the research is significant and relevant in nature it is due to the fact that it deals with the issue of dementia carers making informed decisions making it significant for health sciences.
The originality of a study is largely dependent on the fact if the study provides with new area or dimension associated with the research topic. Basing on the above made discussion if the chosen paper is analyzed it may be observed that the aspect of DECIDE manual has been implemented in the study for the purpose of minimizing the decisional conflict on the part of family carers associated with decision making process for dementia patient’s residential place in the future (Lord, 2016). This was a new aspect of research associated with topic area of dementia and decision making as compared to the earlier researches conducted in this arena. This establishes the fact that the study is original in nature.
The hypothesis of the chosen study may be considered to be clear, specific and precise in nature as it clearly specifies regarding its hypothesis which was to primarily evaluate the hypothesis that the family carers who were receiving DECIDE manual intervention will find it useful and relevant. This clearly established the clarity of the research hypothesis (Lord, 2016).
The study design which has been used in the study focuses on mixed method approach wherein exploratory design has been used on the part of the researcher (Lord, 2016). In this context feasibility trial has been implemented.
Appropriate Way of Evaluating the Research Hypothesis
Exploratory research design is usually implemented and apt in cases of research wherein the topic area has not been explored or lacks in depth study. The main intension in these studies is to establish priorities (Creswell & Creswell, 2017).. Considering the above made discussion if the present chosen paper is analyzed it may be observed that the aspect of implementation of DECISION manual in regards to decision making process for dementia patients has been dealt with in this paper which is a new area of research in regards to decision making for dementia patients. On the basis of this fact it may be stated that the research design in the particular study is appropriate for the purpose of evaluating the hypothesis.
On the part of the researcher clear specification regarding the recruitment process has been specified. The researcher clearly mentioned about the process and the way in which the recruitment process was conducted (Mapstone et al., 2007).. In this regards on the part of the researcher it has been stated that the recruitment occurred within the period of February- July of 2014. The researcher had recruited family carers along with individuals with dementia or clinical diagnosis of Mild Cognitive Impairment. The paper also specifies regarding the inclusion and exclusion criteria.. In this regards the family carers who were mainly informal carer and possessed the sufficient skills for English language were included and carers under the age of 18, in case of carers with clinical concerns and lack of ability of providing with informed consent went were excluded. Thus the above discussed aspects clearly reflect the appropriateness of the recruitment strategy for analyzing the aims of the research.
In regards to the affectivity of the data collection in the process of addressing the research issue it may be observed that the researcher aimed at recruiting 40 carers, 20 into each arms from Islington, Camden and Haringey memory clinical setting. Other than that clear specification regarding the associated focus groups and the ways of data collection has been specified. In this context piloting, follow-up telephonic interview and face-to-face follow-up interview and semi structure interview has been used (Lord, 2016). In regards to recording the interview, all the information were digitally audio recorded and transcribed verbatim. It helped in ensuring that the recorded information is true. In regards to data saturation, on the part of the researcher it has been stated that on judging data saturation, recruitment was ceased. On the basis of the above specified facts it may be stated data collection was effective in addressing research issue.
Recruitment Strategy
On the part of the researcher clear focus on the relationship between participants and researcher may be observed which can be noticed from the fact that issues associated with selection bias, observer bias, instrument bias, attribution bias, statistical bias have been focused upon on the part of the researcher (Lord, 2016).
On the part of the researcher it may be observed that ethical approval had been obtained from National Research Ethics Service Committee London, Bloomsbury. From Enfield and Haringey Mental Health Trust, Camden and Islington NHS Foundation trust and Barnet the researcher has obtained NHS Research and Development approvals (Lord, 2016). This clearly establishes the fact that ethical issues have been taken into consideration on the part of the researcher.
In the present study it may be observed that the researcher has not supported the conclusion with relevant data. In the conclusion, on the part of the researcher it has only been specified regarding the outcome of the study wherein, on the part of the researcher it has been stated that with the help of implementation of DECISION model the carers were benefited in the deicion making process.
On the part of the researcher clear specification regarding data analysis has been stated. In this context it may be observed that analysis plan was based on Braun and Clarke’s thematic analysis: familiarization with coding, data, reviewing, searching for and naming themes and writing up (Lord, 2016). Basing on the above discussed fact it may be stated that the data analysis of the study was robust.
References
Creswell, J. W., & Creswell, J. D. (2017). Research design: Qualitative, quantitative, and mixed methods approaches. Sage publications.
Khan, J. A. (2011). Research methodology. APH Publishing Corporation.
Lewis, S. (2015). Qualitative inquiry and research design: Choosing among five approaches. Health promotion practice, 16(4), 473-475.
Livingston, G., Leavey, G., Manela, M., Livingston, D., Rait, G., & Sampson, E. et al. (2010). Making decisions for people with dementia who lack capacity: qualitative study of family carers in UK. BMJ, 341(aug18 1), c4184-c4184. doi: 10.1136/bmj.c4184
Lord, K. (2016). The decide study: dementia carers making informed decisions feasibility rct. Alzheimer’s & Dementia, 12(7), P301. doi: 10.1016/j.jalz.2016.06.544
Mapstone, J., Elbourne, D., & Roberts, I. (2007). Strategies to improve recruitment to research studies. Cochrane database of systematic reviews (Online), (2), MR000013.
Neuman, W. L. (2013). Social research methods: Qualitative and quantitative approaches. Pearson education.
Prince, M., Bryce, R., Albanese, E., Wimo, A., Ribeiro, W., & Ferri, C. P. (2013). The global prevalence of dementia: a systematic review and metaanalysis. Alzheimer’s & dementia: the journal of the Alzheimer’s Association, 9(1), 63-75.
Robinson, O. C. (2014). Sampling in interview-based qualitative research: A theoretical and practical guide. Qualitative Research in Psychology, 11(1), 25-41.
Warner, M. (2013). Originality: challenges in Chinese HRM research. Journal of Chinese Human Resource Management, 4(2), 117-120.
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